Ohio's measles epidemic appears to be winding down, according to the Ohio Health Department, as cases of mumps, while slowing, continue to infect people.

The last confirmed case of measles was in Holmes County on June 30, which epidemiologist Brian Fowler says puts the outbreak's unofficial end at July 21 and the official end at Aug. 11, or the conclusion of two 21-day incubation periods.

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Measles In Ohio leveled off at 368 reported cases with 10 people hospitalized in nine counties - mostly in the state's Amish country - The Columbus Dispatch reported Friday.

The outbreak started among Amish in Knox County who had traveled to the Philippines, which has had a measles epidemic.

Measles symptoms usually appear seven to 21 days after exposure and can include a fever followed by a cough, a runny nose and a rash on the face that spreads down the neck and body over several days. People with measles are also often sensitive to light and must stay in dark rooms.

Measles are at a two-decade high in the United States, driven by outbreaks among unvaccinated populations of Amish in Ohio.

Knox County, with the largest number of cases, hasn't had a confirmed case since June 11, making the official end of the epidemic there July 23, said Pam Palm, a county health department spokeswoman.

Among the Amish who weren't vaccinated, reasons varied, from basic "benign neglect" to a feeling they didn't need the shot because measles were so rare, according to health officials.

Health officials are urging anyone without the vaccination to get the three-shot vaccine which also covers mumps and rubella.

"It's possible that we'll see a few sporadic cases as it winds down and it's always possible it will increase again, but we're doing everything to prevent that from happening," said Fowler, the Health Department's chief of vaccine-preventable-disease epidemiology.

Ohio had 461 cases of mumps as of Wednesday but the numbers are slowing, said Columbus Public Health spokesman Jose Rodriguez. Many early cases were contracted by Ohio State students.

The central Ohio mumps outbreak has surpassed the total number of mumps cases nationally last year.